Frankly Speaking About Family Medicine

Toddlers and Screen Time—How Much Is Too Much? - Frankly Speaking Ep 423

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-423
Overview: The use of electronic devices has increased across all ages, cultures, and socio-economic levels. Usage was also affected by the COVID-19 pandemic. There is a growing body of evidence that screen time can impact cognition and executive function in developing minds, and both the American Academy of Pediatrics (AAP) and the WHO have recommendations on screen time exposure for children. Join us as we discuss recent evidence looking at the impact of screentime on toddlers’ cognition and executive function over time. 
Episode resource links:
Fitzpatrick, C., Florit, E., Lemieux, A., Garon-Carrier, G, Mason, L. Associations between preschooler screentime trajectories and executive function. Academic Pediatrics, Volume 0, Issue 0, 102603.
Schmidt-Persson J, Rasmussen MGB, Sørensen SO, et al. Screen Media Use and Mental Health of Children and Adolescents: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2024;7(7):e2419881. doi:10.1001/jamanetworkopen.2024.19881
AAP Screen Time Guidelines
Schmidt-Persson J, Rasmussen MGB, Sørensen SO, et al. Screen Media Use and Mental Health of Children and Adolescents: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2024;7(7):e2419881. doi:10.1001/jamanetworkopen.2024.19881
Raj D, Ahmad N, Mohd Zulkefli NA, Lim PY. Stop and Play Digital Health Education Intervention for Reducing Excessive Screen Time Among Preschoolers From Low Socioeconomic Families: Cluster Randomized Controlled Trial. J Med Internet Res. 2023;25:e40955. Published 2023 May 4. doi:10.2196/40955
Guest: Susan Feeney, DNP, FNP-BC, NP-C
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

The Wine Debate: Cardiovascular Benefits Vs Cancer Risks - Frankly Speaking Ep 422

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-422
Overview: Conflicting data on alcohol’s health effects leave clinicians uncertain about patient guidance. In this episode, we review the PREDIMED trial’s findings on wine and cardiovascular outcomes, explore objective biomarkers for intake, and examine the National Academy of Sciences’ recent report to clarify the risks and benefits of moderate consumption, giving you confidence in counseling patients.
Episode resource links:
Inés Domínguez-López, Rosa M Lamuela-Raventós, Cristina Razquin, et al. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial, European Heart Journal, 2024;, ehae804, https://doi.org/10.1093/eurheartj/ehae804
 
 
National Academies of Sciences, Engineering, and Medicine. 2025. Review of Evidence on Alcohol and Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/28582
 
Guest: Robert A. Baldor MD, FAAFP
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

The Nurse Practitioner Will See You Now - Frankly Speaking Ep 421

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-421
Overview: Join us as we discuss a recent meta-analysis examining randomized controlled trials to investigate healthcare costs, quality of care, and patient well-being when delivered by advanced nurse practitioners (ANPs). Explore the evidence behind ANPs’ effectiveness and their potential to enhance patient outcomes while optimizing healthcare resources.
Episode resource links:
Melati Fajarini, Agus Setiawan, Chien-Mei Sung, Ruey Chen, Doresses Liu, Chiu-Kuei Lee, Shu-Fen Niu, Kuei-Ru Chou, Effects of advanced practice nurses on health-care costs, quality of care, and patient well-being: A meta-analysis of randomized controlled trials, International Journal of Nursing Studies, Volume 162, 2025,104953, ISSN 0020-7489, https://doi.org/10.1016/j.ijnurstu.2024.104953
The miseducation of America’s nurse practitioners, July 24, 2024 
 
 
Perloff, J., Clarke, S., DesRoches, C. M., O'Reilly-Jacob, M., & Buerhaus, P. (2019). Association of State-Level Restrictions in Nurse Practitioner Scope of Practice With the Quality of Primary Care Provided to Medicare Beneficiaries. Medical care research and review : MCRR, 76(5), 597–626. https://doi.org/10.1177/1077558717732402
 
Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2021). State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review. Medical care research and review : MCRR, 78(3), 183–196. https://doi.org/10.1177/1077558719901216
 
Taylor K (2023) Bridging the Gap to Health Care Access: The Role of the Nurse Practitioner. Int Arch Public Health Community Med 7:091. doi.org/10.23937/2643-4512/1710091
Guest: Susan Feeney, DNP, FNP-BC, NP-C, Jill M. Terrien PhD, ANP-BC 
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

“I Guess I Won’t Have Another”—Alcohol and Cancer Risk - Frankly Speaking Ep 420

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-420
Overview: Listen in as we discuss the US Surgeon General’s new advisory on the impact of alcohol on cancer incidence and mortality. We review the latest data, explore alcohol’s role in carcinogenesis, and provide evidence-based guidance to help you counsel patients on safer consumption and cancer prevention.
Episode resource links:
U.S. Surgeon General Issues New Advisory on Link Between Alcohol and Cancer Risk | HHS.gov
Guest: Jillian Joseph, MPAS, PA-C
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

Fluoride in Drinking Water: Why Is There Controversy? - Frankly Speaking Ep 419

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-419
Overview: Water fluoridation has been an area of periodic controversy since it was first introduced in the 1950s. This episode dives into recent reports on the benefits and potential impacts of water fluoridation on children’s IQ. Gain valuable insights and feel prepared when addressing patient questions about this topic.
Episode resource links:
Taylor KW, Eftim SE, Sibrizzi CA, et al. Fluoride Exposure and Children’s IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online January 06, 2025. 
Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856. 
Schluter PJ, Hobbs M, Atkins H, Mattingley B, Lee M. Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA Pediatr. 2020 Oct 1;174(10):969-976
Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

My Tummy Hurts—Reasonable Options for Fluid Replacement in Mildly Dehydrated Children - Frankly Speaking Ep 418

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-418
Overview: Acute episodes of nausea, vomiting, and diarrhea due to gastroenteritis in children are common complaints seen in primary and urgent care settings. Join us as we discuss recent evidence suggesting that apple juice can be as effective as commercial electrolyte solutions, offering a cost-effective and convenient option for oral replacement therapy for mild dehydration.
Episode resource links:
Freedman SB, Willan AR, Boutis K, Schuh S. Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial. JAMA. 2016;315(18):1966-1974. doi:10.1001/jama.2016.5352
Goldman RD, Friedman JN, Parkin PC. Validation of the clinical dehydration scale for children with acute gastroenteritis. Pediatrics. 2008;122(3):545-549. doi:10.1542/peds.2007-3141
Jauregui J, Nelson D, Choo E, et al. External validation and comparison of three pediatric clinical dehydration scales. PLoS One. 2014;9(5):e95739. Published 2014 May 2. doi:10.1371/journal.pone.0095739
https://primarycarenotebook.com/pages/haematology/world-health-organization-who-scale-for-dehydration
AAP: Signs of Dehydration in infant and children
https://primarycarenotebook.com/pages/haematology/world-health-organization-who-scale-for-dehydration
Guest: Susan Feeney, DNP, FNP-BC, NP-C 
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

A Matter of the Heart—Screening Guidelines for Cardiovascular Disease - Frankly Speaking Ep 417

Credits: 0.25 AMA PRA Category 1 Credit™
 
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-417
 
Overview: Joseph is a 57 year old male who presents today for his routine annual exam. He is a healthy male, who is active and has no complaints today. He reports that since he was seen last he generally has been doing well but did have a ER visit for persistent cough in the setting of recovering from Covid. While in the Emergency Department he did undergo testing. On a CT Chest scan there was an incidental finding of moderate coronary artery calcifications.  He asked today, what does moderate coronary artery calcification? Is my heart ok, my dad had a heart attack at 60. 
 
Episode resource links:
https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke#:~:text=Heart%20disease%20and%20stroke%20can,and%20high%20cholesterol%20through%20treatment.
Vikulova, D. N., Lee, M. K., Humphries, K. H., Pinheiro-Muller, D., Dawes, M., Pimstone, S. N., & Brunham, L. R. (2024). Preventive Lipid-Lowering Therapy and Interactions With Health Care in Patients Who Develop Premature Coronary Artery Disease. JACC: Advances, 101316.
 
Maron, D. J., Budoff, M. J., Sky, J. C., Bommer, W. J., Epstein, S. D., Fisher, D. A., ... & DeMaria, A. N. (2024). Coronary Artery Calcium Staging to Guide Preventive Interventions: A Proposal and Call to Action. JACC: Advances, 3(11), 101287.
https://www.cdc.gov/heart-disease-family-history/about/index.html
 
Guest: Mariyan L. Montaque, DNP, FNP-BC
 
Music Credit: Matthew Bugos
 
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 

My Back Still Hurts! Nonpharmacologic Approaches to Chronic Back Pain - Frankly Speaking Ep 416

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-416
Overview: Listen in as we discuss chronic sacroiliac (SI) dysfunction and the role of nonpharmacological therapies, including acupuncture, in managing back pain and improving function. Hear evidence-based considerations for integrating acupuncture into your practice to offer effective, medication-free options for patients with chronic SI pain.
Episode resource links:
Kim G, Kim D, Moon H, et al. Acupuncture and Acupoints for Low Back Pain: Systematic Review and Meta-Analysis. Am J Chin Med. 2023;51(2):223-247. doi:10.1142/S0192415X23500131
Mu J, Furlan AD, Lam WY, Hsu MY, Ning Z, Lao L. Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev. 2020;12(12):CD013814. Published 2020 Dec 11. doi:10.1002/14651858.CD013814
Tu J-F et al. Acupuncture vs sham acupuncture for chronic sciatica from herniated disk: A randomized clinical trial. JAMA Intern Med 2024 Oct 14; [e-pub]. (https://doi.org/10.1001/jamainternmed.2024.5463)
Wu M, Fan C, Liu H, et al. The Effectiveness of Acupuncture for Low Back Pain: An Umbrella Review and Meta-Analysis. Am J Chin Med. 2024;52(4):905-923. doi:10.1142/S0192415X2450037X https://www-dynamed-com.umassmed.idm.oclc.org/condition/sciatica
Guest: Susan Feeney, DNP, FNP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

It’s Time to Equip Patients with PEP - Frankly Speaking Ep 415

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-415
Overview: Join us as we discuss the role of postexposure prophylaxis (PEP) in reducing the incidence and adverse outcomes of sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis. Discover when, why, and how to prescribe PEP to better provide your patients with effective prevention options to help reduce rising STI rates and disproportionate impacts on women.
Episode resource links:
Stewart, J., Oware, K., Donnell, D., Violette, L. R., Odoyo, J., Soge, O. O., ... & Baeten, J. M. (2023). Doxycycline prophylaxis to prevent sexually transmitted infections in women. New England Journal of Medicine, 389(25), 2331-2340.
https://www.cdc.gov/sti/php/from-the-director/doxy-pep-sti-prevention-strategy.html#:~:text=Doxy%20PEP%20has%20proven%20to,syphilis%2C%20chlamydia%2C%20gonorrhea).
Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

Is Standing Better than Sitting for Decreasing Cardiovascular Risk? - Frankly Speaking Ep 414

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-414
Overview: Standing desks are a popular choice for people with sedentary jobs who want to increase their physical activity. In this episode, we look at the latest data on the benefits and risks of prolonged standing and provide actionable strategies to help patients reduce cardiovascular risk through informed movement choices.
Episode resource links:
Ahmadi MN, Coenen P, Straker L, Stamatakis E. Device-measured stationary behaviour and cardiovascular and orthostatic circulatory disease incidence. Int J Epidemiol. 2024 Oct 13;53(6):dyae136. doi: 10.1093/ije/dyae136. PMID: 39412356; PMCID: PMC11481281.
Guest: Alan M. Ehrlich, MD, FAAFP 
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com